Old Forum

I see your point about what do you have to lose. Is there an Peyronies Disease doctor near Toronto? I have a very limited knowledge of ESWT. I think there is little objectice documentation of it working and no real consistant standard on the equipment, technique used, or the schedule of treatment. The same criticism can be made of most Peyronies Disease treatments however.

Do they prefer patients in the acute (early) stage or the cronic stage after the Peyronies Disease has stabilized?

Old Forum

There has to be something to the ESWT. I *think* that it's not used here for anything other than stones (kidney, gall), but I have read of athletes, particularly a few baseball players, who have gone to Europe to use ESTW for muscle problems, particularly with their knees. I don't know why the FDA is behind on this one, but nevertheless. If anyone finds anything out, please advise!

My urologist recently mentioned a new unproven approach using a hand-held device (I believe it was ultrasound) but hasn't said anything yet about trying it. Maybe I'll ask about it on my next visit, since VI therapy has done nothing for me and my curve has worsened. Please describe the technique further and keep us informed as to any results you get.

Since this is pretty new territory, the first experience-based info will most likely come from yourself.By the way, can we assume that those nodules (that you describe as being close to the body) are NOT new ones that developed after starting the ultrasound?

I thought I'd answer a few of the questions posed. I own/run the Peyronies Disease clinic in Oakville, Ontario (near Toronto) that does the ESWT treatment. We have been treating Peyronies Disease for about 2.5 years now. Success is good for men with well defined lumps. More info is available on our website, (www.painfree-eswt.com) or by calling us. Go to the research section, and we also have some patient reports.

There is another clinic operating at Tulane University in New Orleans (not sure of current status), at least one clinic in England and probably more, and one in Germany. There are other doctors expressing interests in the US, and other locations.

So far, from about 200 men treated, we haven't had trauma, just some minor tenderness/bruising in a few cases. We do not agree that treatment is mor effective on older plaques. Our Urologist will consider ESWT after more conservative treatments have bee tried (eg. waiting 6-12 months for spontaneous remission, treatment with Vitamin E)

Hawk is correct that there is no standardized treatment yet among researchers/therapists. However a search of MedLine or similar European engines does return quite a bit of research.

I am in the UK and have been refered by my GP to an NHS Urologist but have been on a 38 week waiting list since May. My GP says that Peyronies Disease is treated by using ESWT. I am having doubts about this treatment at the moment from what I have read on various forums about the potential for further damage. I am currently looking at trying a VED having not had any success from various alternatives such as Nattokinase, Serrapeptase, Naprinol, PABA but have stuck with 800iu of vitamin E.

Right, Kevin, the nodules as well as what feels to be lines of hardened tissue (such as veins perhaps) existed BEFORE using ultrasound therapy.

I had to suspend my therapy for several weeks due to extreanous events. However, I have begun again.Possibly the "little" finger node has reduced.......a little......but not enought to make a claim.

To others...........an Untrasound devise must be used as per instructions that come with the devise. Keep the devise moving, 1 inch per second.I am doing about 4-5 minutes per session, 1 session per day.However........I can no reason not to apply therapy 2 times a day.

I´m not with a lot of free time...................but when I obtain certain although minimum results........I WILL inform the forum.

Good luck to all............be inventive................and we can solve this condition.Bo

I finally got to see an NHS urologist a few weeks ago but he does not recommend ESWT and said the best it could do would be to soften the plaque a bit. Even so he said that the procedure is carried our regularly in the area he covers and I could try it if I wanted. As he was of the opinion that the treatment did not work I declined his offer. He said he freqently carries out Nesbit surgery but that the postion of my plaques near the glans did not make that an option. I told him that I had an indent an upward curve near the glans and that the glans did not errect fully so he said I could come back and see him in 6 months for an implant but also suggested using viagra. As I feel viagra may have played a part together with trauma in my conditon it is something I am reluctant to try again. To try and improve things I am currently using a VED and I am also considering using Thackers formula.

Years ago, when I was working as an ER physician, I worked out a deal with PT/OT to use the US machine for a "problem" (can't recall what I said it was) after hours in the middle of the night, when business was slow. I used the ultrasound as it had been done in some clinical reports. It didn't seem to do anything for my Peyronies Disease. I felt warm while doing it and afterwards, but saw no longterm effects.

Tim

Logged

52, Peyronies Disease for 30 years, upward curve and some new lesions.

I am an occuaptional therapist living with peyronie's. I was trained on the use of therapeutic ultrasound prior to me first using it on a patient. Anyone can be trained to use it for a specific condition in a matter of moments, but the outcome is affected by who does the training.

The 1Mhz unit may be benificial, but probably not much.....yes, it does go down into about 2-4 cm of tissue, but right near the surface the heat isn't the strongest. Those who are using it may feel that their hand holding the penis steady is heating up directly under the unit.

Also, it is important to have the correct size ultrasound head. The entire head must be in contact with skin or the ultrasound unit can be damaged....damaged can mean that its performance is unreliable.....become stronger or weaker....

There are contraindications with ultrasound....if you have cancer, you do not want to use it near the cancer site as you can cause the cancer to worsen and even have them enter other areas of your body......this is very bad....

Also, too much heat on the testies can cause sterilization.......and the testies are very close to all pyronie's lesions..for those where sterilization isn't an issue, please remember the testies produce not only sperm, but also testosterone..You do not want to damage any part of the body affecting this as low testosterone may influence the progression of peyronies....

You can burn tissue with therapeutic ultrasound....I have accidently burned patients....the burns go deaper than skin...usually the tissue under the skin can burn first.....also, any bone tissue in the line of the ultrasound can be damaged.....basiclly feels like a bone bruse......it hurts a lot....Those using 1Mhz ultrasound units must remember that your hand has many bones in direct line of use and in the highest degree of heat.....

Please, talk to your physician prior to trying this approach....

As to the units shown for $50 on the internet link above, I really have to question its effectiveness. First, a medical ultrasound device by law can be sold only to people certified in its use....how e-bay gets around this, I don't know......

Second, some of the ad's claims are questionable....melts cellulose? In that case, any heat would melt away cellulose, unless they mean burning tissue (cellulose and all).....

The ad also said it was based on technology only available in the last decade....well, ultrasound technollogy has been around a lot longer than that....

As a beauty treatment? Well, I saw a picture of a person using one on her face...and if it goes 6 inches deep, then she would be cooking her brain.......well...it would explain her using it again, I guess....

The cheap units may work fine, but if they are not honest about their advertising, then how can you trust them with your penis??

I really hope everyone gets some benefit from any therapy they pursue......I found ultrasound therapy usefull for me....It reduced a few curves I have.....They do use ultrasound to reduce bone spurs.....so it could be affective for the plaque that has hardend to calcium....that was my thinking when I pursued it.

Best wishes to everyone and please feel free to email me if you have any questions....I don't have all the answers, but I may have some Ultrasound provides heat to all tissue it comes in contact with....

Oh....My wife is a massage therapist and she said she never heard of spas or massage clinics using ultrasound....

One more thing, If you are interested in pursuing ultrasound, your physician may not know how to use one, but may instead send you to a physical therapy clinic so that a therapist can show you how to safely go through the treatment. Also, chiropractors use ultrasound a lot and may be able to show you how to safely use one....

Here is a research paper that used ultrasound as part of their treatment. Remember, get some training from a professional prior to using ultrasound (even the units purchased from companies selling to the public):

Objective: Peyronie disease is a localized and progressive fibrosis. It is characterized by a plaque in the tunica albuginea, which leads to penile deformity, making sexual intercourse difficult, if not impossible.

Design: During a 4-yr period, we treated 35 patients, aged 30-62 yr, in different stages of this disease. We applied ultrasound therapy (0.5 W/cm; 10 min), infrared radiation, and iontophoresis with 8% potassium iodide (0.2 mA; 30 min). The patients were taught to administer therapy by themselves. The patients' diseases were classified into three stages on the basis of subjective symptoms and clinical findings. At the beginning of treatment, 20 patients' diseases were classified as being in the first stage, 13 patients' diseases in the second stage, and 2 patients' diseases in the third stage.

Results: By the end of treatment, 10 patients were cured, 17 patients' diseases were classified as being in the first stage, 8 patients' diseases were in the second stage, and there were no patients in the third stage.

Conclusions: The method is simple, safe, painless, and inexpensive. Patients were taught to administer the therapy by themselves. There were no side effects. Functional improvement and the cessation of pain were noted by all the patients. The level of improvement depended on the disease duration, the length of therapy, and the stage of the disease.Peyronie disease is a localized and progressive fibrosis that effects the tunica albuginea of the penis (Fig. 1). Francois de la Peyronie was the first to describe this disease in 1743. 1 The cause of this disease is still unknown. Antigen frequencies of HLA-DR2 and HLA-DQW2 were detected by histocompatibility leukocyte antigen (HLA) typing, 2-4 which suggests a possible autoimmunologic origin. Pathoanatomically, fibrosing plaques are clearly limited to the dorsal side of the penis. Lateral localization is not common, and ventral localization is extremely unusual. An excessive deposition of collagen gives rise to a plaque, which is initially fibrotic and then becomes calcified. 5 Diagnosis is established on the basis of anamnesis and clinical examination. The symptoms of Peyronie disease include subjective complaints: pain in the penis, distortion of the penis during erection, disturbance during coitus, and occasional impotence. Figure 1: Peyronie disease is a localized and progressive fibrosis that effects the tunica albuginea of the penis.The indurations are distinctly limited from their surroundings and of a solid consistency. The skin above is free and mobile. The indurations never affect the corpora cavernosa. The size and number of the indurations vary with each individual. The differential diagnosis includes benign and malignant tumors. 6 Causal therapy is not possible because of the unknown origin.Therapy includes local injections (corticosteroid, anesthetic, hilase preparation, and verapamil) for local infiltration of the plaques 7 and oral orgotein, 8 tamoxifen, 9 and collagenase, 10 etc. Roentgen radiation and radiotherapy are also used. 11, 12 Surgical treatment can be used in selected cases. 13-15 Physical therapy includes laser therapy, infrared radiation, ultrasound, and iontophoresis of various drugs. 16-18 MATERIALS AND METHODS TOP During 4 yr (1995-1999), 35 patients were included in a prospective study. All patients had been previously treated with local injection therapy (Hilase (Forschunginstitut, Dessau), corticosteroid, and anesthetic) in the plaque, but without satisfying results. The patients were between 30 and 62 yr (mean age, 50 yr). The duration of the disorder in the patients was more than 6 months. After physical examination and after the stage of illness was determined by the urologist, all patients were sent to the Department of Physical Medicine and Rehabilitation for treatment.The patient's disease was classified into one of three stages on the basis of subjective symptoms and clinical findings. The most important criteria for determining the stage of the illness was the presence of pain during erection with the possibility of coitus: stage I-periodic and spontaneous pain in the penis, less penile pain during erection, no curvature of the penis, intercourse possible; stage II-spontaneous pain during erection, penile curvature during erection, intercourse painful (mostly impossible); stage III-penile curvature expressive, decreased erection, intercourse impossible.If the patient's disease was between two stages, his disease was classified as being at the heavier stage. During examination, which was compulsory after every series of physical procedures, the level of improvement and possible change of the illness stage were determined. Every series consisted of ten ultrasound therapies, ten infrared radiations, and ten iontophoresis with 8% potassium iodide. The time interval between the series was 6 wk at least. All patients underwent all three kinds of therapies in the series. The patients were taught to use the therapy themselves (Fig. 2). Figure 2: The patients were taught to administer the therapy themselves.We started every treatment with ultrasound therapy. The continual insonation lasted 10 min (intensity 0.5 W/cm2), according to the principles of ultrasound, in the series of ten procedures.A further series of ten radiation treatments of the penis with infrared rays, lasting 15 min at a distance of 50 cm, followed as an introductory procedure of iontophoresis (Fig. 3). Figure 3: Iontophoresis.As the active electrode for iontophoresis with 8% potassium iodide, we used a cathode (7 × 5 cm) on the induration of the penis and a different electrode (3 × 3 cm) on the front side of the upper leg (duration, 30 min).RESULTS TOP At the beginning of treatment, 20 patients were classified with diseases in the first stage, 13 patients with diseases in the second stage, and 2 patients with diseases in the third stage (Fig. 4). Figure 4: Beginning of treatment.By the end of treatment, 10 patients were cured, 17 patients were classified as having first-stage disease, 8 patients as having second-stage disease, and no patients had third-stage disease (Fig. 5). Figure 5: End of treatment.The sharp line to normal tunica albuginea disappears during therapy. Induration plaque is divided into several smaller plaques, which are separated by normal tunica of different consistencies. Pain during erection disappears after one or two series in 80% of the patients. The series was repeated, depending on the results of the treatment, two to ten times (mean, 4 times). If the stage of illness was lower, fewer series were required. The treatment was finished when the patient was satisfied with the results of the treatment.By the end of treatment, ten patients were cured (no traces of illness in morphologic and functional forms). Two patients with stage III illness of long duration had their diseases classified to a milder disease stage, stage II (penis curvature was less, erection was possible with less pain; however, coitus was not possible).Six patients' diseases remained at the same stage (stage II). Although the improvement that appeared in all of these patients was both subjective and objective (diminishing pain and softening plaque), the main criterion for the first stage of illness was not fulfilled, the possibility of coitus.Seven patients' diseases were reclassified from stage II to stage I because after therapy, they satisfied all the criteria of that stage. Ten patients' diseases remained at stage I. Although their objective problems disappeared and their functional status was satisfying, the plaque traces were still present, so we did not consider them cured.CONCLUSION TOP The results of this study may be summarized as follows. After 4 yr of using this therapy, we can conclude that this method is simple, safe, painless, and inexpensive. Patients are taught to administer the therapy by themselves, which they tolerate well, and there were no side effects. Functional improvement and the loss of pain were noted with all patients, but the level of improvement depended on disease duration, the length of using the therapy, and the stage of the disease. If the stage of illness was lower, fewer series were needed.REFERENCES TOP 1. Dunsmuir WD, Kirby RS: Francois de la Peyronie (1678-1747): The man and the disease he described. Br J Urol 1996; 78: 613-22 [Fulltext Link] [Medline Link] [Context Link] 2. Ralph DJ, Mirakian R, Proyor JP: The immunological features of Peyronie's disease. J Urol 1996; 155: 159-62 [Fulltext Link] [Medline Link] [CrossRef] [Context Link] 3. Rompel R, Mueller-Eckhardt G, Schroeder-Printzen, et al: HLA antigens in Peyronie's disease. Urol Int 1994; 52: 34-7 [Context Link] 4. Rompel R, Weidner W, Mueller-Eckhardtg : HLA association of idiopathic Peyronie's disease: An indication of autoimmune phenomena in etiopathogenesis. Tissue Antigens 1991; 38: 104-6 [Medline Link] [Context Link] 5. Anafarta K, Beduk Y, Uluogu O, et al: The significance of histopathological changes of the normal tunica albuginea in Peyronie's disease. Urol Nephrol 1994; 26: 71-7 [Context Link] 6. Huang DJ, Stanisic TH, Hansen-KK : Epithelioid sarcoma of the penis. J Urol 1992; 147: 1370-2 [Medline Link] [Context Link] 7. Levine LA, Merrick PF, Lee RC: Interlesional verapamil injection for the treatment of 90 Peyronie's disease. J Urol 1994; 151: 1522-4 [Context Link] 8. Primus G: Orgotein in the treatment of plastic induration of the penis (Peyronie's disease). Int Urol Nephrol 1993; 25: 169-72 [Medline Link] [Context Link] 9. Ralph DJ, Brooks MD, Bottazzo GF, et al: The treatment of Peyronie's disease with tamoxifen Br J Urol 1992; 70: 648-51 [Medline Link] [Context Link] 10. Gelbard MK, Linder A, Kaufman JJ: The use of collagenase in the treatment of Peyronie's disease J Urol 1985; 134: 280 [Medline Link] [Context Link] 11. Rodrigues CI, Njo KH, Karim AB: Results of radiotherapy and vitamin E in the treatment of Peyronie's disease. Int J Radiat Oncol Biol Phys 1995; 31: 571-6 [Medline Link] [Context Link] 12. Viljoen IM, Goedhals L, Doman MJ: Peyronie's disease: A perspective on the disease and the long-term results of radiotherapy. S Afr Med J 1993; 83: 19-20 [Context Link] 13. Rigand G, Bekger RE: Corrective procedures for penile shortening due to Peyronie's disease. J Urol 1995; 153: 368-70 [Context Link] 14. Kim ED, Mc Vary KT: Long-term follow up of treatment of Peyronie's disease with plaque incision, carbon dioxide laser plaque ablation and placement of a deep dorsal vein patch graft. J Urol 1995; 153: 1843-6 [Fulltext Link] [Medline Link] [CrossRef] [Context Link] 15. Perovic S, Milosevic A, Djordjevic M: The new approach to the surgical treatment of Peyronie's disease. Eur Urol Video J 1999; 6: 5-7 [Context Link] 16. Mantovani F, Mastromarino G, Colombo F, et al: Non-surgical therapy of impotence: Infiltration iontophoresis, ultrasound, laser. Arch Ital Urol Nefrol Androl 1992; 64: 255-61 [Medline Link] [Context Link] 17. Mazo VE: A new method for treating Peyronie's disease. Khirurgiia(Sofiia) 1989; 42: 30-1 [Context Link] 18. Felipetto R, Vigano L, Pagui GL, et al: Laser and ultrasonic therapy in simultaneous emission for the treatment of plastic penile induration. Minerva Urol Nefrol 1995; 47: 25-9

Design: During a 4-yr period, we treated 35 patients, aged 30-62 yr, in different stages of this disease. We applied ultrasound therapy (0.5 W/cm; 10 min), infrared radiation, and iontophoresis with 8% potassium iodide (0.2 mA; 30 min). The patients were taught to administer therapy by themselves. The patients' diseases were classified into three stages on the basis of subjective symptoms and clinical findings. At the beginning of treatment, 20 patients' diseases were classified as being in the first stage, 13 patients' diseases in the second stage, and 2 patients' diseases in the third stage.

Tried ESWT around 18 months ago(privately at a Glasgow Hospital) with no noticeable improvement and the only effect being a small surface bruise which disappeared after a few days.The staff administering the therapy did say they had experience of the treatment being effective.The cost was around £1200

Define effective? They probably can't, see I''ve become so skeptical now, after seeing a study on TV and using it, and it not working. Now I saw a more credible study on the IONO, coming from Dr. Levine, now I'm using it and it isn't working. From now on for me to believe a treatment to work it will take more than one or two, or even three studies. After my IONO I'm better off trying alternative treatments no matter how crazy they sound, the medically proven treatments aren't working. Even in Dr. Levine's study he can't conclude that verapamil is working, he said it could be the electrical current alone.

I haven't talked to one person(and I've talked to a lot) that said ultrasound therapy worked. I think a british guy who waited months to get it done, just recently reported on here he saw no results, Tim the doctor, also said awhile back because he is a doctor, got a hold of an ultra sound unit and tried it, with absolutely no results. I don't know if they used these so called pulsed ultra sound sequences. I wonder if sometimes we try to connect the dots to much between one treatment to healing one kind of connective tissue, to peyronies. I do realize we must keep experimenting and trying new things though.

Haven't read up on it much, I don't think Dr. Levine or Dr. Mulhall recommend this type of treatment for peyronies. I have yet to see a single credible study saying it works. I haven't heard one person tell me they tried it and it worked. I don't rule it out as a possible treatment for peyronies but I'm skeptical these days, after so many things not holding through as successful treatments, even with studies backing them up. I don't even think my local urologist would allow me to have this kind of treatment, considering they won't give me a penile ultrasound.

What I found to be interesting on Infrasonic healing is that it produces hyaluronic acid in the scar tissues, making it dissolve. If you look up hyaluronic acid you find that they have been using it recently injected into scar tissue with success. It is something you may already looked into, I will keep you posted on my findings. Thanks.

Location Text Here - Recent studies are revealing how purring may be the secret to cats' nine lives. CHI Institute is the first to release studies that conclusively corroborate the healing results from infrasonic sound waves on humans and other animals.

Recent unreleased studies from the Fauna Communications Research Institute in Hillsborough, North Carolina have given evidence of the healing effect of purring in cats. Scientists there have determined that the frequency at which many cats purr, between 27 and 44 hertz for house cats, matches the frequency that seems to help human bones strengthen and grow. Biologists still don't know what generates purring in felines. They do know that cats purr, not only when they are happy, but also when injured. They heal quickly from bone and tissue injuries caused by impact of falling great distances.

Cats are not the only creatures that use sound for healing. Even humans have been measured emitting varying degrees of low-frequency sound waves. The Beijing Acoustics Institute found that Qi-Gong healers emit up to 100 times the level of infrasonic waves as the average person emits, and up to 1,000 times greater than those emitted by the infirmed. Chinese researchers built a device that replicated the patterns and frequencies of the Qi-gong healers. After they discovered clinical evidence of healing from the devices, CHI Institute founder, Richard Lee, teamed up with the Chinese engineer, Lu Yan Fang, to create a more precisely tuned device for improved reliability and effectiveness.

Twelve years later, CHI Institute is the first organization to present conclusive evidence proving the healing effect of sound from several independent research studies. The studies show that infrasound therapy improves measurements in EEG, EKG, thermogram, and AST/CPK diagnostic enzyme levels. In April 2002, a serological study performed by Ronald Riegal, DVM, showed improvement in the form of an increase in hyaluronic acid quality and concentration in joint lubrication after using CHI Institute's Equisonic QGM on joints in horses.

In addition to the scientific studies, thousands of medical doctors have already observed first-hand the results of therapeutic infrasound. Merle Janes, MD states, "I am using the machine in daily practice. I tried it on my cat, and she immediately flopped down, curled up and half-closed her eyes and purred away. Must've seemed to her like her momma cat had come back."

While 35% of CHI Institute's customers report near-miraculous results in improving their acute and chronic ailments, 96% of users report satisfactory to excellent benefits from infrasound therapy for reducing pain and and inflammation, improving circulation and accelerating the healing process.

The four years period in the study (post below on ultrasound) refers to a period of time during which data wre collected. As not all patients walk in on the same first day, but rather trickle in over time, one needs to look at a group of patients over time to see trends. If one looks at enough patients in four years, then that is when you collate data and write it up. The problem with a 30 year study like that is that other therapies change a lot, so cause and effect is harder to see.

As ultrasound therapy becomes more sophisticated - hopefully as any therapy becomes more sophisticated - we will see more clearly how it might help us (or not). I am unsure of the data presented - like many that have come before, it is not really controlled or blinded.

Tim

Logged

52, Peyronies Disease for 30 years, upward curve and some new lesions.

What I'm reading is that the infrasonic is suppose to increase the hyaluronic acid in the area, which only healthy tissue can survive, this is why the scar tissue dissolves and promotes the healthy tissue to rebuild. So read the articles. Any thoughts on this Brothers?

Injectable hyaluronic acid (HA) derivatives are the most used reabsorbable dermal fillers for soft tissue augmentation today and their utilization is considered safe. We report a cutaneous granulomatous reaction that developed in a woman 5 weeks after the first treatment with a nonanimal HA derivative for the correction of facial wrinkling. We describe the clinicopathological findings and course of the cutaneous reaction. The adverse reaction showed clinical and histopathological characteristics comparable to the few previously reported cases. All cutaneous lesions spontaneously disappeared without scars within 3 months. We conclude that even nonanimal injectable HA derivatives can be associated with delayed granulomatous reactions. The patient should be informed of this potential long-term complication.

Human Anti-Hyaluronic Acid Antibodies: Is it Possible? Patrick Micheels, MD Background. Although hyaluronan has been acknowledged as being free of species and organ specificity, for 4 years I have encountered a variety of adverse reactions to injectable hyaluronic acid as used in aesthetic medicine.

Objective. I have tried to prove that some of those side effects may be allergic reactions to the commercial preparations of injectable hyaluronic acid.

Methods. I began with intradermal tests to the reactive patients and to 2 witnesses; then lymphocyte transforming tests were performed at the University of Geneva (Switzerland). Histology was performed on the skin tests and on reactive treated areas of the face of different patients. A serum analysis was then done by Pr. Sainte Laudy of Laboratoire Pasteur—Cerba (France).

Results. The skin tests were positive for one or the other or both of the injectable hyaluronic acid preparations used in aesthetic medicine. The different biopsies have shown for some a chronic inflammatory reaction, even 11 months after the treatment or a severe granulamatous reaction to foreign bodies. Serum analysis revealed positive antibodies against Restylane and/or Hylaform and even IgG and E anti-hyaluronic acid.

Conclusion. Since 1995, I have 8 patients with adverse reactions to injectable hyaluronic acid, which after several tests, may be allergic to those products. Isn't it time to introduce intradermal tests before any injection of this type, as done with injectable bovine collagen?

So far, from about 200 men treated, we haven't had trauma, just some minor tenderness/bruising in a few cases. We do not agree that treatment is mor effective on older plaques. Our Urologist will consider ESWT after more conservative treatments have bee tried (eg. waiting 6-12 months for spontaneous remission, treatment with Vitamin E)

Hawk is correct that there is no standardized treatment yet among researchers/therapists. However a search of MedLine or similar European engines does return quite a bit of research.

Tim, do you have any more information on the ultrasound therepy? I would assume that this is something you would have to continue doing on an intermittent basis, since the cause of Peyronie's is probablly still present. Any news?

The following is an abstract of an self-evaluation that the PainFree ESWT clinic in Toronto Canada claims to have achieved. This was sent directly to me by The PainFree clinic. I certainly make no claim, or endorsement. I have no reason to either accept or reject this data but present it as it was presented to me.

INTRODUCTION AND OBJECTIVES: ESWT has been described as a noninvasivetreatment modality for patients with Peyronie’s Disease (Peyronies Disease). Our previous research suggests this treatment is an efficacious and minimal sideeffect method of treating Peyronie’s Disease (Peyronies Disease). To date we have treated over 250 Peyronies Disease patients, and report on our latest experience of 53 Peyronies Disease patients treated with ESWT at a single Canadian institution.

METHODS: 57 patients underwent ESWT for Peyronies Disease from January 2006 to February 2007 at ourcenter. A prior diagnosis of Peyronies Disease made by a urologist was necessary for referral to our center. Patients were asked to stop all bloodthinners one week prior to procedure. Peyronies Disease assessment was done by the center’s urologist and, if appropriate candidate, proceeded with ESWT. Treatment consisted of 6 treatments of 30005000 shocks to Peyronie’s plaque over four consecutive days at power level 68 using a Siemens Sonocur lithotripter.

Pre and post treatment questionnaires were filled, and the patient contacted 46Weeks after treatment. Data from the questionnaire was categorized in a conservative manner. Only 'Yes' was counted as an affirmative answer; 'No', 'unsure', 'forgot', 'can't tell' were all counted as a negative response.

Data was collected from 53 of the 57 patients treated at this time. The sample size for each question varies from 17 to 49 respondents, as not all symptoms applied to all patients. For example, only 17 of 53 patients had pain.

RESULTS: Of the 53 patients, all underwent successful ESWT. There were no procedure relatedcomplications. Average age was 54 years and 8 months, and patients had the disease for an average of 2.6 years. 75.5% (37 of 49) of patients reported improvement in the Peyronie’s plaque, characterized by decrease in size and thickness of the plaque. 63% (31 of 49) of patients reported improvement in the degree of penile curvature. 82% (14 of 17) patients reported decreased pain with erections and intercourse.

Patients were also asked subjective questions about the quality of their erection. 45% and 39% ofrespondents felt that some penile length, and girth had been improved. 60% reported improvement in hardness, and 75% (30 of 40) felt penetration had been enabled, or improved. The baseline was lower as some patients were not sexually active, or did not answer the question.Approximately 19% of patients reported no change in condition after treatment.

CONCLUSIONS: ESWT is a reasonable noninvasive option for the treatment of Peyronie’sDisease. Complications and side effects are minimal. Results to date indicate 75% of patients reportdecrease in plaque size, 63% report decrease in penile curvature, and 82% decrease in penile pain. Longer term followup is necessary to evaluate efficacy.Disclosure: All authors have received financial support from PainfreeESWT

Any treatment ever suggested in this forum has had someone who said it helped. Some of the treatments were not accepted as credible by most members. Yet some reported improvement. My point is patient surveys are inherently flawed. EWST may prove to be the greatest therapy ever. This report does not prove it, though.

There's now a whole group of therapies - like ESWT, TV, cold laser, and hyperthermia - that are claimed to work on Peyronie's, but no mention is ever made of Dupuytren's. I think there's a simple reason for that: they don't work, and that would be blindingly obvious if they were tried on Dupuytren's contractures.

They also represent existing products, with no development costs, looking for new markets. Peyronie's is an easy market to enter because there's currently no effective non-surgical treatment to compete with.

It is true that Easterling's (PDL) web site still refers to Dupuytren's but as I know, no one tries it for DC anymore. A few years ago he spammed the BSTC Dupuytren's message board and a few people tried it. As far as I know it did nothing, and I think Easterling has stopped marketing it for Dupuytren's.

I think you make some good points. I tend to agree but this time you got my brain activated and I wonder if it has ever even been tried on DC. I also ask if everything that works on one should just be accepted as working on the other? One is a ligament and one is specialized tissue. I think of pentox, arginine, and PDE5 inhibitors. You could argue they are not known to work or that N.O. is not a factor with DC, but maybe the last point actually addresses my point. If the fabled Lariche technique works, could it be that ESWT has a similar action of breaking the plaque especially if used in conjunction with traction?

There is no argument that existing technology is a cheaper attempt, but existing technology cannot just be dismissed on those grounds. New applications for existing technology are found every single day.

Besides being strongly statistically linked, at the cellular level it appears they're essentially the same condition - fibroblasts gone haywire, producing an extracellular matrix of inelastic collagen. None of these therapies has the ability to break the molecular bonds of those collagen molecules in sufficient numbers to make any difference. It's been hypothesized that verapamil enhances production of collagenase (which lyses collagen) in adjacent cells; however it seems no one can get that to work in the human body.

Dupuytren's doesn't modify the ligaments, although Dupuytren's tissue may attach to them. Here's a link to one of several studies I've seen over the years leading to the conclusion (which is actually stated in this abstract) that what works for one should probably work for the other. Note that AA4500/Xiaflex is effective on both; that's because the tissue is the same.